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Unsafe clinical practice

Our case studies are based on real life fitness to practise concerns we have received

Type of concern: Unsafe clinical practice

Profession: Biomedical scientist

Standards

When these events happened, previous versions of the standards were in place (standards of proficiency for biomedical scientists 2014 and standards of conduct, performance and ethics 2012). To avoid confusion the most recent versions are shown.

Standards of conduct, performance and ethics (1 September 2024)

  • 6.1 You must take all reasonable steps to reduce the risk of harm to service users, carers and colleagues, as far as possible.
  • 6.2 You must not do anything, or allow someone else to do anything, which could put the health or safety of a service user, carer or colleague at unacceptable risk.
  • 2.6 You must work in partnership with colleagues, sharing your skills, knowledge and experience where appropriate, for the benefit of service users and carers.
  • 2.7 You must share relevant information, where appropriate, with colleagues involved in the care, treatment or other services provided to a service user. 
  • 8.1 You must be open, honest and candid when something has gone wrong with the care, treatment or other services that you provide by:
    - where applicable, alerting your employer of what has gone wrong and following the relevant internal procedures;
    - informing service users and where appropriate carer, or where you do not have direct access to these individuals the lead clinician, to inform them that something has gone wrong;
    - providing service users and carers with a detailed explanation of the circumstances in which things have gone wrong and the likely impact; and
    - taking action to correct the mistake if possible and detailing this action to the service user and where appropriate, their carer.
  • 8.2 You must apologise to a service user and/or their carer when something has gone wrong with the care, treatment or other services that you provide.

Standards of proficiency for biomedical scientists (1 September 2023)

  • 4. Practise as an autonomous professional, exercising their own professional judgement

Case study

A biomedical scientist’s employer raised concerns following an incident where the registrant failed to follow procedure. When processing samples, the registrant failed to prevent contamination, which led to inaccurate results.

The registrant attended the hearing and was represented. While it was a one-off incident, the Panel felt it was not due to a lack of understanding, knowledge or training. The Panel felt these were deliberate acts and contrary to the standard operating procedures. It resulted in blood samples having to be retaken. Additionally, there was a potential risk of harm if clinicians had acted on the contaminated results. Therefore, the Panel felt the registrant’s conduct fell well below the standards expected of a biomedical scientist. The incident was sufficiently serious to constitute misconduct. The Panel felt that the misconduct was remediable. However, it felt that the registrant had not demonstrated that it had been remedied. In addition, there was a risk of repetition, given the extreme pressures of the work environment. The Panel also felt the following clear message needed to be given to the public and to other registrants: it is not acceptable for a biomedical scientist to make a deliberate decision to not follow mandatory standard operating procedures. Therefore, the Panel found the registrant’s fitness to practise was impaired on both the personal and public component.

The Panel then went on to consider what sanction to impose which would be sufficient to protect the public. The Panel felt a conditions of practice order would be sufficient. The conditions required the registrant to undertake training and the preparation of a personal development plan to ensure the registrant was able to manage their workload effectively, even when subject to stress, so that the registrant wasn’t tempted by shortcuts or to take risks.

Measures we put in place to protect the public

The Conduct and Competence Committee imposed a twelve-month conditions of practice order.

 

Published:
14/01/2019
Resources
Learning material
Subcategory:
Case study
Audience
Registrants, Employers
Profession
Biomedical scientists
Page updated on: 31/08/2024
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